Provider Demographics
NPI:1225398142
Name:CAPO MARTINEZ, MARIA DEL MAR (MD)
Entity type:Individual
Prefix:
First Name:MARIA DEL MAR
Middle Name:
Last Name:CAPO MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 NICHOLLS RD
Mailing Address - Street 2:STONY BROOK UNIVERSITY MEDICAL CENTER LEVEL2-766
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7025
Mailing Address - Country:US
Mailing Address - Phone:631-444-2224
Mailing Address - Fax:631-444-3419
Practice Address - Street 1:101 NICHOLLS RD
Practice Address - Street 2:STONY BROOK UNIVERSITY MEDICAL CENTER LEVEL2-766
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7025
Practice Address - Country:US
Practice Address - Phone:631-444-2224
Practice Address - Fax:631-444-3419
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program